Related Experiment Videos
Ceftriaxone prophylaxis in cardiovascular surgery in children
Insights
A single dose of Ceftriaxone effectively prevents infections in closed heart surgery. Open heart surgery patients may require additional Ceftriaxone doses due to longer procedures and potential complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Prophylaxis
Background:
- Peri-operative antibiotic prophylaxis is crucial in preventing surgical site infections.
- Ceftriaxone is a commonly used antibiotic for surgical prophylaxis.
Purpose of the Study:
- To evaluate the effectiveness of Ceftriaxone prophylaxis in patients undergoing closed and open heart surgery.
- To compare infection rates and post-operative outcomes between different surgical types and Ceftriaxone regimens.
Main Methods:
- Prospective study of 50 patients divided into two groups: closed heart surgery (Gr I, n=24) and open heart surgery (Gr II, n=26).
- Gr I received a single 50 mg/kg IV dose of Ceftriaxone. Gr II received the same initial dose plus a second dose 24 hours later.
- Data collected included duration of surgery, post-operative fever, hospitalization, and infectious complications.
Main Results:
- No infectious complications were observed in the closed heart surgery group (Gr I).
- Open heart surgery patients (Gr II) experienced infectious complications including pneumonitis, pleural effusions, and wound infections (36.8%).
- Mean post-operative fever and hospitalization durations were longer in Gr II compared to Gr I.
Conclusions:
- A single dose of Ceftriaxone is adequate for peri-operative prophylaxis in closed heart surgery.
- Open heart surgery, particularly with factors like tissue hypoxia or prolonged drainage, may necessitate extended Ceftriaxone treatment (2-3 additional days).
Abstract:
Fifty patients undergoing closed and open heart surgery were prospectively studied for the effectiveness of peri-operative prophylaxis with Ceftriaxone. Twenty-four patients (Gr I) that underwent closed heart surgery received 50 mg/kg single dose of Ceftriaxone given intravenously at the start of anesthesia. Twenty-six patients (Gr II) that underwent open heart surgery received 50 mg/kg. Ceftriaxone given intravenously at the start of anesthesia followed by another 50 mg/kg 24 hours later. The mean duration of surgery in Gr I was 1.7 hours and Gr II was 4.2 hours. The duration of post-operative fever in Gr I ranged from 0-4 days (mean 2.4) and Gr II ranged from 1-13 days (mean 6). The duration of post-operative hospitalization in Gr I ranged from 5-18 days (mean 9) and Gr II ranged from 7-71 days (mean 19). Early and late infectious complications were not found in Gr I. Late infectious complications were not found in Gr I. Late infectious complications in Gr II consisted of 2 cases of pneumonitis, 5 pleural effusions and 1 staphylococcus aureus would infection (36.8%). We concluded that a single dose of Ceftriaxone should provide adequate prophylaxis for closed heart surgery. An additional 2-3 days of daily dose Ceftriaxone may be needed when associated with tissue hypoxia, longer duration of intravenous lines and drainage tubes in open heart surgery.